Competence-based performance evaluation in hospital nurses

Objective to evaluate the frequencies attributed to the professional competences of hospital nurses, discussing the ones that obtained higher and lower frequencies. Method descriptive, cross-sectional, quantitative study with 45 nurses of a hospital of high complexity in the interior of São Paulo state. The study used the Competences Evaluation Questionnaire, translated and validated in Brazil, composed of 27 items in five domains: professionalism, communication, management, nursing process and problem solving. Data were analyzed using descriptive statistics. Results it was found that 80% of the participants were female and 20% were male. The age ranged between 25 and 63 years, with an average of 40.02 years, and the average length of professional experience was 13.39 years. The competences “Communication with the hospital’s administrative staff” and “Participation in scientific research and / or application of results” had the lowest frequencies, while “Commitment to punctuality and workload” and “Commitment to the ethical principles of the profession” were evaluated with the highest frequencies. Conclusion evaluating the performance by competences becomes essential for managers and training centers, since it contributes to the identification of gaps in knowledge, skills and attitudes of professionals, by promoting the elaboration and implementation of strategies for their development.


Introduction
The professional competences have been the object of concern and attention for the managers, and even for the nurses who work in the management and in the care. In this sense, identifying and developing them became a challenge and focus of interest for all actors involved, especially in the hospital setting (1) .
In this respect, the routine and systematic evaluation of the frequency of nurses' competences has gained attention among educators, health managers and other professionals in different spheres, allowing to rescue the profile of competences, their trajectory and the achievement of objectives along the professional career (2) .
The nurse who works in the hospital service stands out for the technical responsibility in caring, both for his or her know-how and for the activities developed by the team, without neglecting the administrative part that this nurse may be responsible for. This multiplicity of actions requires the development of specific skills for professional practice at the level of excellence. In this perspective, managers should be concerned with the assessment of the professionals' performance through instruments that evaluate their competences for the working praxis. Thus, having an instrument that identifies existing competences and those that need to be acquired becomes significant for distinguishing the singularity of actions for a professional practice which is safe, humane and with no risk to the client, the nurse or the institution (3) .
In view of this, the performance evaluation represents an essential tool that can characterize the profiles of professionals, that is, their cognitive, procedural and attitudinal knowledge, in this case especially of nurses and based on this diagnosis, to build and implement strategies to promote their learning. Thus, it is noteworthy to emphasize that this type of evaluation is increasingly disseminated in academic and organizational scenarios, given its capacity to provide management aligned with corporate strategic objectives and individual expectations (4) .
In this context, a study pointed out the need to build a specific instrument capable of verifying the professional competence of nurses working in emergencies, anchored in the profile of the professional, the client, the institution and the Brazilian public policy for the care in this area, according to a proper methodology (3) .
Moreover, it is important to highlight that the processes of characterization of professional profiles can begin even before the stage of hiring the workers, that is, during the selection and recruitment process carried out by the institution, since this movement also assists in the adequate allocation of workers, so that they effectively correspond to the position established. In this case, the personnel manager must establish a plan for the recruitment and permanent education processes, since misleading hiring has a negative impact on the performance of each function, directly reflecting on job satisfaction, on the professional engagement, as well as on the evaluation of results for the users and financial resources (5)(6) .
Thus, in view of the complexity of hospital organizations, of the increasing demands of users of these services and for activities performed by nurses, this study assumes that some competences needed for the execution of these activities may be lacking for these professionals.
In this context, the following questions are presented: Which competences are more frequently noticed by hospital nurses during their professional practice? What competences need to be developed?
Regarding the relevance of this subject, it is possible to notice that in the area of health, the daily professional practice of nurses has not been regularly evaluated, largely due to the management model implemented. In this perspective, this research can allow the identification of higher and lower frequency competences within the hospital by the nurses themselves, with the purpose of preparing a worker with innovative and creative performance, capable of a social and critical reflection/ action, an individual who constructs knowledge for the professional practice of Nursing. He or she may also help in the construction of Pedagogical Political Projects whose central axis is the training of nurses by competences.
Thus, the present study aims to evaluate the frequencies attributed to the professional competences of hospital nurses, discussing the ones that obtained higher and lower frequencies.

Method
It is a descriptive, cross-sectional study, using a quantitative approach. The study scenario was a public teaching hospital institution, reference in urgent and emergency care and located in the interior of São

Results
In the studied population of 45 nurses, we found that 80% (n=36) of subjects were female and 20% (n = 9) were male. The age ranged between 25 and 63 years,    It is common knowledge that a hospital organization is considered effective and efficient when it presents excellence in quality and a good performance of its human capital (8) .
In view of this, when nurses have an ethical attitude and responsibility to commit themselves to work and to users, this makes them an empowered professional able to make decisions in the most varied situations of daily work.
Thus, being assiduous and respecting the workload, is how nurses, through the collective construction, achieve forms of leadership, relationship, communication and action, strengthening both the professional and the user of health services, through the valorization of the reciprocal relationship between work and interaction (9) .
In association with the issue of punctuality and professionals, also serving as a tool in the search for success and for obtaining organizational results, since in a hospital people perform functions of extreme importance, so it is essential for them to be well informed, so that they can become involved and participate in managerial actions, helping the accomplishment of predetermined goals and objectives (13) .
Regarding the relevance of effective communication feelings and expose the conflicts that are happening in their work process is extremely relevant (17) .
Moreover, in addition to strategies to stimulate Corroborating this fact, it has been observed that nurses tend to seek only specialization courses, since masters and doctoral degrees, although allowing some conditions for the quality of care, are associated with projects to build a teaching career (22) . And this premise also does not seem to cause any impact on the organization.
In this context, scientific research in nursing is implementation alternatives (24) .

Conclusion
The study allowed to evaluate the frequencies of hospital nurses' competences, allowing the application of learning-teaching strategies to be developed in the work context.
Regarding the lower frequency competences, we